Fractional CO2 Laser for Acne Scars Treatment: A Comparative Analysis of Ablative vs. Combined Ablative and Non Ablative Modalities

Objective: As acne scars remain challenging to treat. This study compared the safety and efficacy of two carbon dioxide (CO2) laser systems for acne scars treatment. Methods: Between 2022 and 2024, 88 patients were treated for acne scars using either the ProScan applicator, delivering dual fractional CO2 ablative (10,600 nm) and nonablative (1570 nm) lasers, or the LiteScan applicator, which delivers ablative CO2 (10,600 nm) laser alone. Clinical efficacy was assessed using the Echelle d'Evaluation Clinique des Cicatrices d'acne (ECCA) scale. Results: Both groups showed significant improvements in ECCA scores post-treatment (p < 0.001, Wilcoxon Signed-Rank Test). However, the percentage change in scores from baseline to post-treatment did not differ significantly between the groups (p > 0.05, Wilcoxon Rank-Sum Test). Adverse effects were mild and transient, resolving within a few days, with no significant differences between the groups (p > 0.05, Chi-square test). Limitations: This study is limited by its retrospective design and the absence of a control group. Conclusion: Both laser systems demonstrated high efficacy and safety in treating acne scars, with significant post-treatment improvement in scar severity.